Appendix D
Appendix D
Diabetes Mellitus and Epilepsy Care Planning with Parent-Designated Adult (PDA) in Washington Schools
Diabetes Mellitus and Epilepsy Care Planning with Parent-Designated Adult (PDA) in Washington Schools
DIABETES
Planning for the care of students with diabetes in schools requires collaboration with everyone involved. All partners share the goal of keeping students healthy and ready to learn. The following sections provide role definitions that may assist the team to develop the plan of care.
PARENT/GUARDIAN ROLE:
Knows student and specific strengths and needs. Parent will be fully involved with planning. The parent may but is not required to choose a Parent-Designated Adult (PDA). If they choose a PDA, the parent also must arrange for the PDA to be trained by a health care professional or expert in diabetic care such as a diabetic educator. The parent cannot provide this training. Training is paid for by parent.
PARENT-DESIGNATED ADULT (PDA) ROLE:
• The PDA is a non-paid volunteer and can be a community member or a school staff member.
• The Parent-Designated Adult (PDA) role must be defined in writing and included in the IHP and the ECP. It must be recognized that the PDA is working under requests by the parent, but those activities should be included in the IHP so that everyone knows “who is doing what and when.” Use the “Guidelines for Care of Students with Diabetes” ,OSPI Bulletin # 61-02, September 18, 2002, and Curriculum Standards for Developing Curricula to Train Parent-Designated Adults Working with Students with Diabetes Mellitus (2009) to read specifics of training for PDA and sample forms for documentation of that training.
REGISTERED NURSE ROLE:
• Comprehensive nursing assessment; review medical records; interview parent; interview student; interview staff members who have been working with the student.
• Develop Emergency Care Plan.
• Develop Individual Health Care Plan/504 Plan.
• Train school personnel on signs and symptoms of hypoglycemia/hyperglycemia and their role in the Emergency Care Plan.
• Monitor student’s health status on a regular (sometimes daily) basis.
• Modify care plans when needed.
• Support child and family within scope of practice.
• Provide ongoing, selected school staff training and support for care of specific student needs.
• Conduct annual all-staff training on management of diabetes in the school setting.
LICENSED PRACTICAL NURSE ROLE:
• Work under direction of the professional school nurse
• Contribute to assessment
• Carry out care plan on a day-to-day basis
• Collect and document data
• Report any changes to RN and
• Support child and family within scope of practice.
HEALTH CARE PROVIDER ROLE:
Responsible for medical management and provides medical orders for licensed nursing staff to implement at school. Licensed nurses can only take orders from persons with prescriptive authority. Medical orders cannot be taken from parents.
REGISTERED NURSE ROLE RELATED TO PARENT-DESIGNATED ADULT:
• Registered nurse (RN) develops and monitors comprehensive health care plan that outlines daily management of diabetes at school, support to student, and facilitation of self-management by student.
• Parent-Designated Adult performs specific tasks as directed by parent. RN incorporates tasks performed by PDA into the care plan. RN does not train or supervise Parent-Designated Adult but does monitor health status of student as a result of tasks performed by parent-designated and others.
ADMINISTRATION OF GLUCAGON:
May only be administered by the parent/guardian, PDA, RN or LPN. When Glucagon is administered at school, 911 MUST be called. (See “Guidelines for Care of Students with Diabetes” Washington State Task Force for Students with Diabetes, page 22 & 23.
RESOURCES:
Guidelines for Care of Students with Diabetes 2018,
OSPI Bulletin # 61-02, September 18, 2002,
RCW 28A.210.233-235, Students with diabetes, http://app.leg.wa.gov/RCW/default.aspx?cite=28A.210.330
EPILEPSY
Planning for the care of students with epilepsy in schools requires collaboration with everyone involved. All partners share the goal of keeping students healthy and ready to learn to achieve academic success. The following outline describes some role definitions that may assist the team to develop the plan of care.
PARENT ROLE:
Knows student and specific strengths and needs. Parent will be fully involved with planning. The parent may but is not required to choose a Parent-Designated Adult (PDA). If they choose a PDA, the parent also must arrange for the PDA to be trained by a health care professional or expert in epileptic seizure care. The parent cannot provide this training. Training is paid for by parent.
PARENT-DESIGNATED ADULT ROLE:
• The PDA is a non-paid volunteer and can be a community member or a school staff member.
• The Parent-Designated Adult (PDA) role must be defined in writing and included in the IHP and the ECP. It must be recognized that the PDA is working under requests by the parent, but those activities should be included in the IHP so that everyone knows “who is doing what and when.”
REGISTERED NURSE ROLE:
● Comprehensive nursing assessment; review medical records; interview parent; interview student; interview staff members who have been working with the student.
● Develop emergency care plan (ECP).
● Develop individual health care plan (IHP) if indicated.
● Train school personnel on signs and symptoms of seizures and their role in the emergency care plan.
● Monitor student’s health status on a regular (sometimes daily) basis.
● Modify care plans when needed.
● Support child and family within scope of practice.
● Provide ongoing, selected school staff training and support for care of specific student needs.
● Conduct annual all-staff training on management of seizures in the school setting.
LICENSED PRACTICAL NURSE ROLE:
Work under direction of the professional school nurse, contribute to assessment, carry out care plan on a day-to-day basis, collect and document data, report any changes to RN, and support child and family within scope of practice.
HEALTH CARE PROVIDER ROLE:
Responsible for medical management and provides medical orders for licensed nursing staff to implement at school. Licensed nurses can only take orders from persons with prescriptive authority. Medical orders cannot be taken from parents.
REGISTERED NURSE ROLE RELATED TO PARENT-DESIGNATED ADULT:
• Registered nurse (RN) develops and monitors comprehensive health care plan that outlines daily management of seizures at school, and support to student.
• Parent-Designated Adult performs specific tasks as directed by parent. RN incorporates tasks performed by PDA into the care plan. RN does not train or supervise Parent-Designated Adult but does monitor health status of student as a result of tasks performed by parent-designated and others.
ADMINISTRATION OF MIDAZOLAM:
When Midazolam or Diastat (legend nasal spray medications) are administered at school, 911 SHOULD be called.
RESOURCES:
Washington Law related to intranasal medication RCW 28A.210.260(5), http://app.leg.wa.gov/RCW/default.aspx?cite=28A.210.260
Washington Law related to Parent-Designated adult for epileptic care RCW 28A.210.260(8), http://app.leg.wa.gov/RCW/default.aspx?cite=28A.210.260
Students with epilepsy or other seizure disorders—Individual health plans—Designation of professional to consult and coordinate with parents and health care provider—Training and supervision of school district personnel—Parent-designated adults RCW 28A.210.355 (Effective 2022-23 school year)